Lindsay Larios, assistant professor of social work.
Supplied by Lindsay Larios
For some, a nation’s borders demarcating jurisdictions serve as a symbol of national security. While it may be true that these heavily guarded boundaries provide a sense of safety for a nation’s citizens, they are a source of anxiety for many temporary status individuals living within its confines. One commonly held source of anxiety is access to healthcare.
Lindsay Larios, an interdisciplinary critical policy researcher and assistant professor in the faculty of social work, studies how Canadian citizenship and immigration intersect with the politics and policies of reproduction. Focusing on how governments use administrative categories and jurisdictions to govern and restrict basic access to health resources, Larios’s work considers the broader impacts on race, gender and socio-economic status. She adopts a pragmatic approach to her practice, investigating the role community-based advocacy plays in expanding access and reimagining the power dynamics between governments and citizens.
With a focus on advancing reproductive justice for migrants, Larios’s most recent co-authored project draws on the lived experience of medically uninsured pregnant migrants. This work highlights barriers they have faced in accessing pregnancy-related healthcare and the adverse effects this has caused for their families. Through interviews conducted with different uninsured migrants in Quebec, Larios identified a knowledge gap as they spoke on their experiences in childbearing, health and social service provision.
The final report shows that medically uninsured migrants consist of a multiplicity of heterogenous populations including refugees and asylum seekers, international students and migrant workers. Although it is encouraged for these groups to purchase private health insurance, this is a luxury many cannot afford. Financial costs alone create a significant barrier in accessing prenatal and perinatal care, although the complexity of the system, precarious work and immigration conditions, fear of deportation and refusal of care further contribute to barring migrant access.
Upon examining the impacts of pregnancy on different temporary statuses, Larios found “these programs are not designed to accommodate pregnant people.” While uninsured migrants face physical consequences, the effects of their condition are far-reaching, affecting the trajectory of their lives within national borders. Canada’s policies, Larios explained, disallow migrants from being “fully realized human beings — you come as a migrant worker, you are seen as a worker, and your human needs are supported insofar as they support the labour market.”
The course of an uninsured migrant’s pregnancy is heavily influenced by external factors flowing from their status, causing a loss in decision-making power over one’s body and life more generally. “It’s a moment of intense vulnerability for a lot of people in a way that I don’t think is consistent with the way that we talk about Canada’s overall desire to support reproductive rights,” Larios shared.
Migrant workers, for example, find themselves at the whims of their employers — pregnancy runs the risk of job loss and may lead to employer-constrained access to preferred prenatal care services, including abortion services. “Where [this issue] has come up mostly in my research is not [through] direct [firing], but someone becomes pregnant and some time during [those nine months in] their pregnancy their work permit expires […] We see employers choosing not to renew work permits of pregnant people,” Larios explained. Although the employer may not specify their reasons for termination, “It looks like a de facto firing,” Larios added.
While recourse may be available to migrants for employment losses through administrative tribunals such as the Manitoba Labour Board or the Manitoba Human Rights Commission, power dynamics and accessibility issues often bar migrants from pursuing action. Additionally, few services in Manitoba are equipped to support migrant workers in the specific employment challenges they face.
Ultimately, Larios’s project corroborates existing findings in other Canadian studies that demonstrate the difficulties migrants face in navigating the healthcare system. These include fears of potential Canadian Border Services Agency involvement and anxiety about the quality of care they will receive, all of which further harm migrant health and act as barriers to accessing healthcare.
For Larios, these are all solvable problems. Based on the project’s findings, Larios recommended expanding access to public health insurance, increasing transparency in the availability of information and limiting pregnancy-related health costs. Through the Manitoba Association of Newcomer Serving Organizations, the findings have been transformed into an accessible resource for uninsured individuals.
